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New Service Application

This form must be used by anyone applying for new utility services with Mishawaka Utilities. After completing and submitting this form a customer service representative will reach out via your selected contact method within 24-48 hours if we require additional information. If your request is successfully verified you will receive an automated email with additional instructions and next steps for completing setup of your new services. If you have any questions at any time during the process please call our office at (574) 258-1630 or email us at mubilling@mishawaka.in.gov

Have you previously had service with Mishawaka Utilities?

Yes

No

Please provide your current/previous service address:

Address Line 1:*

Address Line 2:

City:*

Applicant Information

In this section we will collect some basic information from you the applicant as well as your co-applicant if you have one.

First Name:*

Middle:*

Last Name:*

Primary Phone Number*

Phone Type:*

Would you like to opt-in to receive text notifications from us?

Yes

No

Secondary Phone Number

Phone Type:

Email Address*

Would you like to receive your bill via email?

Yes

No

Social Security Number:*

Drivers License,Passport, or State issued ID:

Take Picture/Video

Place of Employment:*

Work Phone Number

Extension:

Co-Applicant Information

Co-Applicant information is required if the person is listed in your lease/welcome letter or purchase agreement.

Would you like to add someone else to your account?

Yes

No

First Name:*

Middle:*

Last Name:*

Phone Number*

Phone Type:*

Employer:*

Social Security Number:*

Drivers License,Passport, or State issued ID:

Take Picture/Video

Relation to Applicant:*

If other please explain:

Page Break

Service Information

In this section we will collect information about the address where you are starting new service.

Please enter the address where you are requesting to start new service

Address Line 1:*

Address Line 2 (apt,suite):

City:*

Zipcode:*

Enter or select the date service will be started? (no weekends or holidays)*

Please note we do NOT offer same day service. If your request is received after 3 P.M. EST it will not be processed until the following business day.

Do NOT submit this application with a service start date greater than 10 days from today.

Do you own or will you be renting this residence?

Own

Rent

For Owners: Upload your deed,closing disclosure or purchase agreement. Only provide the first page showing the address where you are setting service, and the last page showing your signature.

For Tenants/Renters: Upload your lease or welcome letter. Only provide the first page showing the address where you are setting service, and the last page showing your signature.

Take Picture/Video

Will the mailing address be the same as the service address?

Yes

No

Address Line 1:*

Address Line 2:

City:*

State*

Zipcode:*

Terms of Service Agreement

In consideration of the terms and conditions hereinafter expressed, Mishawaka Utilities and the customer agree as follows: MU agrees to furnish customer Electric and/or Water, Wastewater & Trash Service for which the customer agrees to pay on or before the final due date printed on the bill. The rate of charges will be in accordance with the Schedule of Rules and Rates which has been approved by our Municipal Board of Works and members of our Common Council. A copy of the Rate Schedule will be furnished to the customer on request or can be viewed on our website at www.mishawaka.in.gov. Penalties apply when bills are not paid within the specified time. In default of such payments, MU may discontinue service without notice. If either utility service is disconnected or/tagged for non-payment a processing/disconnect charge will be assessed. In addition, the customer will be charged for service fees beyond our normal working hours and will be expected to have payment in full before service can be restored.

It is further agreed that MU shall in no way be liable for any cessation of service due to any defective equipment or unavoidable accident.

By signing or checking the box available, I agree to be bound by the Terms and Conditions of Service of the Electric Department and the Rules and Regulations of the Water Department, which have been approved by the Indiana Regulatory Commission & Municipal Board of Works. Copies are on file at the Mishawaka Utilities Business Office, 126 N Church Street, Mishawaka, Indiana.

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